Treatment of Malaria in the United States

Griffith, Kevin S.; Lewis, Linda S.; Mali, Sonja; Parise, Monica E.

doi:10.1001/jama.297.20.2264

Cited by 212 publications

(166 citation statements)

References 177 publications

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“…Of the 186 uncomplicated cases of P. vivax or P. ovale in men and in women who were not pregnant at the time of diagnosis (primaquine is contraindicated during pregnancy), only 75 (40%) received primaquine, the only antimalarial active against the dormant parasite liver forms and prevents relapses (52). In addition to their treatment for acute malaria, all persons who have mosquito-acquired P. vivax and P. ovale diagnosed and who are not G6PD deficient should receive a course of primaquine for relapse prevention (28).…”

Section: Discussionmentioning

confidence: 99%

Malaria Surveillance — United States, 2013

Cullen¹,

Mace²,

Arguin³

2016

MMWR Surveill. Summ.

101

110

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Problem/Condition: Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is also occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, laboratory exposure, or local mosquitoborne transmission. Malaria surveillance in the United States is conducted to identify episodes of local transmission and to guide prevention recommendations for travelers.Period Covered: This report summarizes cases in persons with onset of illness in 2013 and summarizes trends during previous years.Description of System: Malaria cases diagnosed by blood film, polymerase chain reaction, or rapid diagnostic tests are mandated to be reported to local and state health departments by health care providers or laboratory staff. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System, National Notifiable Diseases Surveillance System, or direct CDC consultations. CDC conducted antimalarial drug resistance marker testing on blood samples submitted to CDC by health care providers or local/state health departments. Data from these reporting systems serve as the basis for this report.Results: CDC received 1,727 reported cases of malaria, including two congenital cases, with an onset of symptoms in 2013 among persons in the United States. The total number of cases represents a 2% increase from the 1,687 cases reported for 2012. Plasmodium falciparum, P. vivax, P. malariae, and P. ovale were identified in 61%, 14%, 3%, and 4% of cases, respectively. Forty (2%) patients were infected by two species. The infecting species was unreported or undetermined in 17% of cases. Polymerase chain reaction testing determined or corrected the species for 85 of the 137 (62%) samples evaluated for drug resistance marker testing. Of the 904 patients who reported purpose of travel, 635 (70%) were visiting friends or relatives (VFR). Among the 961 cases in U.S. civilians for whom information on chemoprophylaxis use and travel region was known, 42 (4%) patients reported that they had initiated and adhered to a chemoprophylaxis drug regimen recommended by CDC for the regions to which they had traveled. Thirty-six cases were reported in pregnant women, none of whom had adhered to chemoprophylaxis. Among all reported cases, approximately 270 (16%) were classified as severe illnesses in 2013. Of these, 10 persons with malaria died in 2013, the highest number since 2001. In 2013, a total of 137 blood samples submitted to CDC were tested for molecular markers associated with antimalarial drug resistance. Of the 100 P. falciparum-positive samples, 95 were tested for pyrimethamine resistance: 88 (93%) had genetic polymor...

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Section: Discussionmentioning

confidence: 99%

Malaria Surveillance — United States, 2013

Cullen¹,

Mace²,

Arguin³

2016

MMWR Surveill. Summ.

101

110

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“…6 Any ill, febrile child who has traveled in a malariaendemic zone (see map at www.cdc.gov/malaria/ risk_map/) in the year before presentation could have malaria. 9 The risk of severe malaria is higher…”

Section: Fevermentioning

confidence: 99%

Evaluating a Sick Child after Travel to Developing Countries

Tolle

2010

The Journal of the American Board of Family Medicine

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Every year, millions of children travel internationally with their families, many to developing countries. Although the vast majority experience uneventful travel and return home well, it is not uncommon for children to present as ill during or after travel. Although the majority of travel-associated illness is mild and self-limited, serious conditions regularly occur. Almost all life-threatening conditions after travel present with fever, and malaria is the most important of these to rapidly exclude. Gastrointestinal symptoms are common after travel in the developing world, and most diarrhea in child travelers has a bacterial source. Children who have a rash in association with fever or who appear ill should receive a priority work-up focused on ruling out serious conditions. Many children traveling internationally experience respiratory illness during or shortly after travel, mainly common upper respiratory infections, yet serious conditions, such as tuberculosis, may occur. Eosinophilia is common in the returned pediatric traveler, particularly those with prolonged stays in the tropics. Not all eosinophilia is caused by parasitic infection; drug reactions, asthma, and other allergic conditions are also common causes.

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“…8 Adverse events of ET were rarely reported, but included fluid overload, transfusion reactions, metabolic disturbances like hypocalcemia, transmissible infection, bleeding, red blood cell alloantibody sensitization, acute respiratory distress syndrome, ventricular fibrillation, and hypotension. 13 Any adverse events did not develop in our patient.…”

Section: Discussionmentioning

confidence: 57%

Exchange Transfusion for Severe Imported Falciparum Malaria with Hyperparasitaemia: Case Report

Güleç¹,

Avcil²,

Ünlü³

et al. 2016

Turkiye Klinikleri J Case Rep

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156 lasmodium falciparum malaria is the most dangerous form of malaria. The World Health organization (WHO) defines severe P. falciparum malaria as one or more of the following features: cerebral malaria, hyperparasitemia (>5% parasitized erythrocytes or >250.000 parasites/µl), severe anemia (hematocrit <15% or hemoglobin <5 g/dL in the presence of parasitemia >10,000 parasites/µL), renal failure (urine output <400 mL/24 hours in adults, with serum creatinine >3 mg/dL), respiratory distress and pulmonary edema, hypoglycemia (whole blood glucose <2.2 mmol/L or <40 Exchange Transfusion for Severe Imported Falciparum Malaria with Hyperparasitaemia: Case Report A AB BS ST TR RA AC CT T Severe falciparum malaria is a potentially fatal infection despite optimal antimalarial treatment. Exchange transfusion is successfully used in severe falciparum malaria with hyperparasitaemia. In this paper, we describe a case of severe Plasmodium falciparum infection in a 23-yearold man. The patient was referred to our emergency department with high fever after returning from Equatorial Guinea. The thin and thick blood smears revealed the presence of P. falciparum ring forms with a parasite density of 30%. P. falciparum infection was confirmed by Polymerase Chain Reaction (PCR). The patient was successfully treated by exchange transfusion in addition to antimalarial chemotherapy. Despite limited evidence of its efficacy in improving survival, exchange transfusion can be used as an-supportive treatment in selected cases where rapid reduction in the parasite load appears necessary.K Ke ey y W Wo or rd ds s: : Malaria; malaria, falciparum; exchange transfusion, whole blood; parasite load Ö ÖZ ZE ET T Şiddetli falsiparum sıtması uygun antimalaryal tedaviye rağmen potansiyel öldürücü bir enfeksiyondur. Exchange transfüzyon hiperparazitemili şiddetli falsiparum malarya olgularında başarıyla kullanılmaktadır. Bu yazıda şiddetli Plasmodium falciparum enfeksiyonu olan 23 yaşında bir erkek olgu tanımladık. Hasta, Ekvator Ginesi'nden döndükten sonra yüksek ateş ile acil servisimize başvurdu. İnce ve kalın yaymalarda %30 parazit yükü ile P. falciparum taşlı yüzük formları saptandı. P. falciparum enfeksiyonu polimeraz zincir reaksiyonu (PCR) ile doğrulandı. Olgu antimalaryal kemoterapiye ek olarak exchange transfüzyon ile başarılı bir şekilde tedavi edildi. Sağkalımı iyileştirmedeki etkinliği ile ilgili veriler kısıtlı olsa da yüksek parazit yükünün hızla azaltılması gereken seçilmiş olgularda, exchange transfüzyon destek tedavisi olarak uygulanabilir.A An na ah ht ta ar r K Ke ek ki im me er rl l: : Sıtma; sıtma, falsiparum; transfüzyon, tam kan; parazit yükü T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J C Ca as se e R Re ep p 2 20 01 16 6; ;2 24 4( (2 2) ): :1 15 56 6--6 60 0Güliz UYAR GÜLEÇ,

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Treatment of Malaria in the United States

Cited by 212 publications

References 177 publications

Malaria Surveillance — United States, 2013

Malaria Surveillance — United States, 2013

Evaluating a Sick Child after Travel to Developing Countries

Exchange Transfusion for Severe Imported Falciparum Malaria with Hyperparasitaemia: Case Report

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